HomeMy WebLinkAboutX2019-0220 - Permit Applicationr ✓I JG't,L)
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Print Form Worksheet for Combo Building & Solar Permit Application a4�`4 °Te
Comm'[ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OP cl InnnlTTni cs
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Description of Work
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# Stories[--zj # Units (if Res)I
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New/Add SF Remodel SF Garage/New/Add �,/
Valuation$
Material/Labor 7;0 C,
OWNER'S NAME Last
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME
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Last First �
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Architect/Designer's Address
Architect/Designer's E-mail Address
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State F_� Zip ���.. Telephone��
ENGINEER'S NAME Last
FirstF� Lic. No.I
Engineer'sAdd ress
Engineer's E-mail Address
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State F_ Zip �— Telephone7�
CONTRACTOR'S NAME/COMPANY
Lic No. F_ ClassF
Contractor's Address
Contractor's E-mail Address
City
State F_-, Zip F—' TelephoneF—,
SETBACKS REAR
SETBACKS FRONT PERMIT NO. XW'l4-�t - SZZ P -
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. ����j� - Z,0
USE ZONE
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DEVELOPMENT NO 'tl t�-(�Gj C, PLAN CHECK FEES $